Keeping Up to Date with Frailty Related Issues

This is the last post in the Frailty Matters Coaching and Teaching programme which you have all been participating in. Frailty and the care of people with frailty, like all areas of health and social care is an area constantly being researched and best guidance on care as a result changes. It is important therefore to keep up to date with what is going on in Frailty care and management so that you and your team continue to deliver the best care possible. So this post is going to offer a few tips for keeping up to date.

The first resource to mention is one that we have used already within the programme, which is the British Geriatric Society Frailty Hub https://www.bgs.org.uk/resources/resource-series/frailty-hub The Hub was created in June 2020 and will be the place where the BGS will hold its national guidelines and best practice relevant to frailty. The BGS also have their own Journal Age and Ageing and on their website they host a collection of articles from the Journal that looks at Frailty in older people. You can access their collection at https://www.bgs.org.uk/resources/age-and-ageing-collection-frailty-in-older-people

The Royal College of Nursing (RCN) also host a a page on frailty where you will find advice and resources on identifying frailty in older patients and choosing the right interventions to help manage their condition. See: https://www.rcn.org.uk/clinical-topics/older-people/frailty

They also have a larger frailty resource held on their magazine website called the RCNi frailty resource collection. https://rcni.com/features/frailty-resource-collection-84906 This is not open access however, you need to be subscriber to one of the RCNi Magazines listed here. https://rcni.com/journals to get access to their online materials.

NHS England has two specialist groups that deal with frailty issues. They are the Acute Frailty Network. Their ‘Guidance and Resources’ pages in particular are useful and worth keeping track of. https://www.acutefrailtynetwork.org.uk/

There is also the NHS Specialised Clinical Frailty Network. on this site you will find a range of tools and resources to support the improvement of NHS specialised services for older people living with frailty.

On the Royal College of GP’s website there is a toolkit that provides a collection of relevant tools and information to assist primary care teams to implement a six-step model of collaborative care and support planning which is very useful for supporting the care a number of patients groups including adults living with frailty. See: https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/collaborative-care-and-support-planning-toolkit.aspx

It is also worth noting that Health Education England, NHS England and Skills for Health provides a single, consistent and comprehensive framework that sets out the skills, knowledge and behaviours expected of any person who is involved in the care and support for people living with frailty. https://www.skillsforhealth.org.uk/images/projects/frailty/Frailty%20framework.pdf?s=form which may prove useful when you are considering your own development and that of the members of your team.

Finally it is worth occasionally using the following terms in Google from time to time just to see what is produced by the Cochrane Library Database of Reviews. They don’t have a specific frailty collection yet but they do very frequently review topics of interest to health and social care professionals looking after people living with with frailty. Search Using “Cochrane Library Frailty” in Google and see what comes up.

Additional Teaching/Learning Resources

When planning the sessions coaching sessions for this project there were two ‘guests’ we were going to invite to discuss their work with you, Janis McDonald who is the Chief Officer of Deaf Scotland who was going to discuss frailty and hearing and sight loss and Alison Bunce, the Programme Lead for Compassionate Inverclyde who is a Queen’s Nursing Institute Nurse. See https://www.qnis.org.uk/queens-nurse/alison-bunce/ who was going to discuss Compassionate Inverclyde with you.

Since they were unable to speak to you in person online they decided to record what they were going to discuss for you to watch. Both videos are below.

The second video is below:

So far in the programme we have been using text and video resources but there are a number of resources that exist in podcast form that we have not utilised. Podcasts tend to be a bit longer than video resources but you can download and listen to them in your own time. So you can listed to them from your ‘phone, on a smart speaker, on a walk, in the car etc.. You can of course also listen to them and share them with your own team and as they tend to be published in series, then you and your team members can listen to those you/they want to hear or feel are most relevant at the time.

The first series we are going to point you to are a series of podcats from Eat Well Age Well is a national project tackling malnutrition in older people living at home in Scotland. Eat Well Age Well is brought to you by award winning Scottish Charity Food Train. The website for the project is at https://www.eatwellagewell.org.uk/

To access the first blog press play below

Their podcasts are all about sharing and discussing how we can support older people in Scotland to eat well, age well and live well. See https://anchor.fm/eatwellagewell#:~:text=Eat%20Well%20Age%20Well%20is,age%20well%20and%20live%20well.

The Royal National Institute for the Blind also have a series of Podcasts to aid in supporting people with sight loss. There are three different podcast series, focusing on:

Each podcast is less than 15 minutes long. They are designed for older people living with sight loss as well as those family members, friends and carers who support them, as well as anyone who supports and helps adults with complex needs – both in a home or care setting.

Another larger podcast resource which has a wider remit than just frailty is a resource called MDT Education on Ageing: which has been designed for anyone working with older adults. They are part of a podcast family of site called the Hearing Aid Podcasts. You can access all of their podcasts (there are 9 series) at http://thehearingaidpodcasts.org.uk/

A guide to all their podcasts can be found at http://thehearingaidpodcasts.org.uk/previous-series/

Dementia: Some Guidance

Caring for people with dementia in the community is one area which is currently expanding. Recently the Alzheimer Europe calculated that with an increasing, and increasingly ageing, UK population the overall numbers of people with dementia; estimated in 2018 to be 1,031,396 will by 2050 be 1,977,399. A rise from 1.56% of the overall population to 2 .67% in 2050. There is pressure therefore to get this right now ahead of this expansion.

There is no clear way to provide all the people and their carers who require support with what they will need, so new ways to provide effective care need to be considered. This blog will look at 3 existing resources that are already being used in Scotland.

The first resource we suggest that you consider using is the winner of the Scottish Digital Health and Care Award 2020; which was NHS Lanarkshire’s Online Post Diagnostic Support Website which you can access from HERE

Two things to be aware of before you go to the site. It might have been designed for people receiving post diagnostic support but the information and advice is far more extensive than this. It has been tailored to suit Lanarkshire, so some sections discuss services and processes available in Lanarkshire which may or may not be available within the NHS Ayshire and Arran area.

The advantage of using this resource is that the information that it provides is validated and conforms to NHS Scotland standards (the information sources and hwere to get more information are all ij the links given within the site). There is 24/7 access to information which you can return to easily. People living with dementia and their carers can all access it when desired. It can be used to enhance staff knowledge of dementia, post diagnostic support and the services which might be available to improve people’s support and experience.

Topics the resource covers include understanding the illness, Power of Attorney, Driving, Anticipatory Care Planning, support for carers and lots more. Please explore this resource and use as you see fit. Note that the easiest way to find the site is to type “Dementia NHS Lanarkshire” into Google.

The second resource you should consider using is the Social Care Institute for Excellence (SCIE) Dementia Gateway. The Dementia Gateway provides access to information, guidance, resources and training for anyone supporting people with dementia. It is a very extensive resource and worth taking a bit of time to explore. There is so much on it designed to be utilised by health and social care staff in the community both as a resource and as education that you will find something your team can utilise very quickly. A note of caution though. It has been designed for England and Wales which is particularly important when the information given refer to English legislation. You can access the Gateway HERE.

The third resource we suggest that you look at is work done by the “Focus on Dementia” Group who are part of Health Care Improvement Scotland. They are currently working on improving care co-ordination for people with dementia and their carers so that this becomes more integrated.

Their work can be found at https://ihub.scot/improvement-programmes/focus-on-dementia/integrated-care/ They have set about trying to identify the critical success factors for integrated care co-ordination of people with dementia in the community. The focus of their work has been Midlothian. Their overview of the Dementia Care Co-ordination Critical Success Factors is available on the site and is discussed in the video that you will find there. A more detailed report on the critical success factors is due to be published but the list of factors is something you might already be able to use. There is also other work done by Focus on Dementia that you can access from this site.

The Value of Social Support

In class yesterday we looked at the value of social support and the damaging effect of loneliness even without the addition of frailty. Social support is the perception and actuality that one is cared for and has assistance available from other people. It requires you to be part of a social network. These supportive resources include

Appraisal support: Information that is useful for self-evaluation; like what should I wear? Should I buy this?

Informational support:  Advice, suggestions, and information

Instrumental support: Tangible aid, for example lending or giving you money, help if you broke your leg, or a service like babysitting for you.

Emotional support: Expressions of empathy, love, trust and caring

Social support can be measured as the perception that one has assistance available, the actual received assistance, or the degree to which a person is integrated into a social network and/or their local community. Support can come from many sources, such as family, friends, pets, neighbours, co-workers or via external organisations.

Below is the Sway that we discussed in class which focuses on tackling loneliness

The BBC Scotland Documentary that was mentioned during the day was called the “Age of Loneliness” and was made in 2016. Its not currently available on the BBC iPlayer but there are many clips from it scattered across the internet. This is the director Sue Bourne discussing making it.

Welcome

Thank you for agreeing to take part in our research study. As you are aware the research is being carried out by the University of the West of Scotland,  The Health and Social Care ALLIANCE ( the ALLIANCE) and NHS Ayrshire and Arran. It is funded by the Burdett Trust for Nursing.

The study aims to increase your skills in managing frailty in the community. We plan to create, deliver and evaluate a person-centred intervention with two components: a coaching programme and an educational intervention on effective and personalised care and support for people living with frailty in the community. To find out more CLICK HERE

Throughout the programme you will be able to provide feedback based on your experience of this training and how it is helping you to support other members of your team in managing frail older people. Your views may help other people affected by frailty in the future by helping the research team to understand what are the key issues in the management of  frailty in the community so that we can help others to identify the best ways to address them.

This Blog is going to act as your teaching resource and will be here for you throughout the study. The plan is to place all the teaching resources used in the sessions on this site and also to post additional information and useful materials we find while the project is running. Note that anything that you see on this site that is BLUE is a link to a useful resource.